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The health care industry has never been known for being full of go-for-broke personality types. Slow and steady is the norm. But in the realm of spending, e-health exploded last year along with pretty much everything else. There was a lot of bandwagon jumping back then when “a pony-tail and a deck of slides got you anything.”

This year, again like pretty much everything else, caution prevails. At the recent e-health 2001 conference in Toronto, a panel discussed whether e-health is in a boom or bust phase.

“I think our time has come…I think Canada is on a huge up-swing,” said David Wattling, CEO of Edmonton-based iW Technologies. He added that Canadian spending in e-health will be in the billions of dollars over the next few years, though this pales in comparison to the tens of billions to be spent in the U.S.

Countries both north and south of the border are feeling the hangover from gleeful unchecked spending last year, Wattling said.

“We didn’t gorge quite as much (on spending) as the U.S. did so we are not feeling the pain,” he added.

He did say, however, that Q1 spending this year is comparable to Q1 spending last year, whereas the drop-off in the U.S. is much more pronounced.

Though there were North American 250 e-health IT companies that met their makers last year, they were replaced by approximately the same number, he said. Though the newer companies are more cautious and more business focused, he added.

John David, president of eBill.ca in Calgary, said visions of dollars dancing in people’s heads was part of the problem

“The cause of a lot of the failures [was] due to unbridled greed,” he said.

Whereas certain sections of the economy embraced technology for technology’s sake, along with its ability to solve business problems, there was a bit of a misread by companies on health care’s desire to jump on board. There was a lot of development spending, but not a lot of end user adoption.

One only need spend a bit of time in the medical domain to realize how traditionalist it is and how glacial changes are.

Though technology can certainly help a lot of health initiatives, such as prescriptions written on wirelessly connected PDAs to avoid hand writing recognition errors, getting end users to adapt to them, the networks in place and the necessary funding on board in times of cut backs is no easy task.

Doctors are not traditionally fearful of technology from a job loss standpoint, as others are, but rather from a “How can this really help me be a better doctor?” perspective.

And that is only part of problem.

The complexity of health care makes it difficult to run a business in this industry, said show attendee Brad Dixon, an independent IT consultant. Companies need deep, deep knowledge of health care before they jump in, he added.

Privacy in health care is another huge issue, with opponents arguing vehemently that their reasoning is superior to others.

“Why is there so much attention being paid to this…security and confidentiality has gone overboard,” said Dennis Niebergal, president of CLINICARE Corp. in Calgary. He said he would want his medical information as accessible as possible so he could get the best care possible.

Brendan Seaton, president of Fredericton-based CareLink Inc., didn’t exactly see eye-to-eye with Niebergal. He said the introduction of government privacy bills will drastically increase demand for privacy solutions.

“Slaying the privacy dragon…is the Holy Grail of health informatics,” he said. But, he added, “the whole concept of privacy is an abstract thing.”

All of the members on the panel agreed that Canadian e-health technology vendors have to look beyond our borders for potential markets and that companies have to have a good business case not just a good health care case in order to succeed.